“It’s not that I feel uncomfortable with myself, but rather how others treat me”—the impact of social interactions and norms on gender dysphoria and euphoria among trans and gender-diverse adolescents

Background Gender incongruence in adolescence is often associated with gender dysphoria (GD). Literature shows that GD is not only inscribed in the body but can also be triggered by reactions from the social environment and points to the concept of social gender dysphoria. Simultaneously, gender euphoria (GE) is fostered by affirmative and supportive reactions. The aim of this study was to explore and conceptualize how social triggers and societal norms shape the experiences of GD and GE in trans and gender diverse (TGD) adolescents.Methodology As part of the participatory research project TRANS*PARENT, five focus groups were conducted, involving 30 TGD adolescents aged 11–18 years. Data were analyzed through qualitative content analysis in collaboration with a community-based group of experts.Results TGD adolescents experienced GD, including body-related distress, primarily in response to social non-affirmation and trans-hostility. They had developed strategies to alleviate GD and foster empowerment. Community settings provided spaces where TGD adolescents felt accepted and seen as their true gendered selves which evoked GE as well as being addressed correctly. Further, adolescents engaged critically with a medicalist view on GD and the pressure to conform to cis-normativity.Discussion Our findings suggest that TGD adolescents experience GD and GE primarily in response to social contexts and the (non-)affirmation of their trans identities which underpins the concept of social gender dysphoria. Although critical of cis- and trans-normativity, adolescents felt the need to pass in order to meet societal expectations of the gender binary and to avoid GD and fear about trans-hostility. This highlights the need for widespread structural interventions to reduce trans-hostility.Conclusion The interplay between (non-)affirmative interactions, social norms and GD should be carefully considered when working with TGD adolescents. Fostering GE should be a main target in transgender health care.